World failing to curb HIV virus: study

By Danny Rose

1 March 2010 — 11:48am

An Australian review of the world's clean needle and methadone programs has shown many countries aren't doing enough to halt the spread of HIV.

Many nations had failed to roll out prevention strategies or had done so on a scale that wasn't preventing the spread of the virus among injecting drug users, according to research by the University of NSW's National Drug and Alcohol Research Centre (NDARC).

Dr Bradley Mathers said Australia ranked among the world's top providers of clean needles for injecting drug users - and just 1.5 per cent of the nation's injecting drug users were HIV positive.

In Russia and the Ukraine, where prevention strategies were non-existent or patchy, the virus had infected almost 40 per cent of these drug users.

"Injecting drug use is an increasingly important cause of HIV transmission in most countries," Dr Mathers said.

"Our findings suggest that, worldwide, there are few countries in which the level of intervention coverage is sufficient to prevent HIV transmission.

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"Governments that have not made needle and syringe programs and opioid substitution available need to be convinced that these interventions are the most effective ways to stop HIV spreading among injecting drug users, and to the wider community."

Dr Mathers said there were an estimated 16 million injecting drug users worldwide, and three million of these were thought to be HIV positive, accounting for 10 per cent of all those living with the virus.

Australian health authorities hand out 213 clean needles per injecting drug user every year, according to the research, compared to 188 in the UK, 46 in Canada and just 22 in the US.

Looking globally, Dr Mathers said only eight per cent of injecting drug users had accessed a needle and syringe program in the past year.

This ranged from an estimated 100 per cent of users in the Czech Republic and Ireland to less than three per cent in the more populous China, Malaysia and Thailand.

Opioid substitution therapy - such as methadone - was available in less than half (70) of the 151 countries with known injecting drug user populations.

Dr Mathers said a notable exception was Russia, which contained the world's second largest injecting population after China but had no opioid substitution therapy.

The research also found only one in every 25 injecting drug users who had contracted HIV were receiving antiretroviral treatment for it.

Chile, Kenya, Pakistan and Russia were the worst in treating those drug users who had contracted the virus.

Dr Mathers said the research highlighted the large discrepancies in HIV prevention measures across the globe, and its effect on the local transmission rates.

Australia was an example of what occurred when access to clean needles and methadone programs were long established and widespread, he said.

"Our high level of prevention in Australia has paid off with low levels of HIV infection among injecting drug users compared with countries with a similar level of injecting drug use," Dr Mathers said.